重症监护临床信息系统的建设与应用

重症监护临床信息系统有效提高了医护人员的工作效率,规范临床诊疗行为。笔者介绍了该系统的主要内容及特点以及在医院重症监护病区的应用,重症监护临床信息系统优化了流程、规范了流程操作、完善了评估体系。对提升医疗质量、提高临床工作效率和设备利用率、发掘信息价值具有重要意义。     

重症监护信息系统的设计与实施

按照＂数字化医院＂建设的目标,我院在重症监护科室引进一套重症监护临床信息系统,通过该系统的实施,实现医疗过程中的生命体征数据等临床信息的数字化和网络化传输、完整共享HIS、LIS和PACS等系统数据、自动生成各种医疗文书,最终达到优化工作流程、降低劳动强度、提高医疗质量、降低医患风险、提升医院效益的目的.     

重症监护临床信息系统的应用

本文介绍了临床重症监护系统在我院的应用，该系统以危重病人的临床护理过程为主线，利用全过程、全方位的管理信息流，按照信息采集、信息整合、信息分析和信息输出的数据流程，建立ICU临床信息数据库，规范了临床重症监护的工作流程，减少了ICU护士记录患者体征和医疗护理文书的手工操作，完善了医疗、护理科研的统计查询分析，提高了工作效率和护理质量，为实现医院临床医疗信息网络化创造了条件。     

重症监护护理的危险因素及对策

重症监护是指对收治的各类危重病患者,运用各种先进的医疗技术,现代化的监护和抢救设备,对其实施集中的加强治疗和护理。以最大限度的确保病人的生存及随后的生命质量。近年来,重症监护护理工作中存在着很多危险因素,提高护理人员的法律意识及护理工作中的防范能力是重症监护护理人员的首要任务。     

重症监护临床监护系统在ICU的应用及体会

作为特殊的医疗现场,ICU收治患者多为急危重症,其工作状态是紧急及严密监护的,在监护过程中,对各种临床数据的采集以及对患者的信息管理要求更高。通过应用重症监护临床信息系统,对监护过程进行数字化、规范化和标准化管理,极大地提高了ICU护理工作的效率和质量。     

综合重症监护病房医院感染干预的临床研究

目的 加强综合重症监护病房的医院感染管理,提高医疗质量.方法 医院感染管理部门建立医院感染管理制度和规范并予督查,实施目标性监测,干预医院感染的发生;综合重症监护病房成立医院感染管理小组,落实医院感染防控措施.结果 通过对医院感染的干预和预防,减少综合重症监护病房的医院感染的发生.结论 多途径加强医院感染管理,严格监控质量,是提高医疗质量、确保医疗安全的可靠保证.     

DoCare重症临床信息系统的建设与应用

重症监护临床信息系统作为临床信息系统的组成,以其产生信息量大、采集数据及时、临床应用紧急、同时共享内容多等特点,在临床信息系统中占有重要地位,通过该系统在我院重症监护病房（ICU）的应用,实现了重症监护过程的规范化和数字化管理,使医疗信息、重症监护信息充分共享,收到了很好的效果。     

重症监护信息系统在临床中的应用

1重症监护临床信息系统的特点 重症监护信息系统把监护仪的患者生命体征值等临床信息采集并且记录下来,护士通过床边电脑系统把护理记录、交班记录、尿量、引流液等内容录入重症监护信息系统中,该系统覆盖了和重症监护相关的各个临床工作环节,能够将ICU的日常工作标准化、流程化和自动化,极大的降低了护理人员的工作负担,提高了整个工作流程的效率,为真正实现以病人为中心的医护过程、     

重症监护护理工作职业危害与防护

近年来,重症监护科(ICU)作为医疗重点学科,得到了广泛重视和迅速发展。从临床实践来看,重症监护病房能够在最大程度上把危重病人集中起来,有利于提供最佳的医疗求助和技术保障,从而确保病人得到良好的救治。由于重症监护病房作为危重病人的密集场所,重症护理工作中往往面临着突发事件多、工作强度大、感染风险高等诸多危险因素,因此,重症监护病房护士面临着比其他科室更大的职业风险与危害,从而危害其身心健康。笔者结合自身护理工作实践,就重症监护护理     

重症监护临床信息系统的应用

介绍了重症监护临床信息系统的内容、特点、流程及与医院信息系统（HIS）的集成，通过该系统在我院重症监护病房（ICU）的应用，实现了重症监护过程的规范化和数字化管理，使医疗信息、重症监护信息充分共享，收到了很好的效果。     

外科ICU护士素质培训方法的探讨

目的提高外科ICU护士的素质。方法通过有经验的护士进行理论讲课,操作示范,亲自带教．培养专业护士应具备的素质。结果通过素质培训,ICU护士在掌握各项基础护理,高难度抢救患者的工作中,显示了高素质护士的良好作风和优势。结论专业护士的素质培洲是适应临床工作需要,解决临床护理问题,提高医疗质量的重要部分。     

全国重症医学专业医疗服务与质量安全调查

目的了解我国重症医学专业医疗服务与质量安全现况。方法采用结构化抽样方法,对全国3 425家不同级别医院重症医学科进行调查,调查内容包括:医疗质量与服务结构指标（床位数、医护人员配备）、控制指标（ICU患者收治率、病死率等）及其完成率等。结果不同级别医院的重症医学专业质量指标存在较大差异,重症医学科资源配置尚不合理,重症医学质量安全仍有待进一步改进提高。结论建立完善的激励和培养机制,加强人才队伍建设,进而壮大和稳定ICU医护队伍。建设远程医疗中心网络,完善区域协同医疗信息平台等智慧医疗设施,探索远程ICU诊疗模式。     

Impact of Performance Obstacles on Intensive Care Nurses' Workload, Perceived Quality and Safety of Care, and Quality of Working Life

Objectives. To study the impact of performance obstacles on intensive care nurses' workload, quality and safety of care, and quality of working life (QWL). Performance obstacles are factors that hinder nurses' capacity to perform their job and that are closely associated with their immediate work system.
Data Sources/Study Setting. Data were collected from 265 nurses in 17 intensive care units (ICUs) between February and August 2004 via a structured questionnaire, yielding a response rate of 80 percent.
Study Design. A cross-sectional study design was used. Data were analyzed by correlation analyses and structural equation modeling.
Principal Findings. Performance obstacles were found to affect perceived quality and safety of care and QWL of ICU nurses. Workload mediated the impact of performance obstacles with the exception of equipment-related issues on perceived quality and safety of care as well as QWL.
Conclusions. Performance obstacles in ICUs are a major determinant of nursing workload, perceived quality and safety of care, and QWL. In general, performance obstacles increase nursing workload, which in turn negatively affect perceived quality and safety of care and QWL. Redesigning the ICU work system to reduce performance obstacles may improve nurses' work.     

Ethical issues and the importance of consensus for the intensive care team

This paper draws upon an empirical study and combines moral philosophical insights and sociological analysis to shed light on the ethical issues in intensive care. It is argued that moral philosophical debate often leaves aside the social context in which ethical decisions are taken and carried through. In order to gain an understanding of how intensive care is accomplished and specifically how ethical issues are handled, the study focused primarily on nurses' accounts of and views on the practices which form the everyday work of intensive care. A qualitative approach was adopted involving theoretical sampling and the constant comparative method of analysis. The paper argues that the most difficult ethical issue in intensive care, namely the withholding or withdrawal of treatment, is an area in which nursing and medical perspectives are often at odds. However, when the social context of clinical practice is taken into account, this paper argues. there is common ground between the two professions. It was found that the period during which the decision to withdraw treatment is being made, the members of the intensive care team closest to the bedside, nursing and medical staff. become impatient for some resolution of the situation. The differences of opinion which arise over the decision to withdraw are not simply to do with the way in which the situation is experienced by each professional group, proximity to the patient had a part to play in shaping their views rather than, as it is sometimes presumed. a simple rift between medicine and nursing. The data suggest that intensive care has to be a team effort. Even though there is no legal requirement for nurses to agree with the ICU decisions, there seems to be a strong desire within the intensive care team that moral consensus should be achieved in the interests of good patient care. Intensive care relies on the integrity of the team and the unfailing functioning of teamwork. Consequently, achieving this, it seems, is more important than other temporary lapses in interprofessional relations and disagreements over treatment in individual cases. Consensus is important and its achievement is a central, day to day working arrangement for insuring the solidarity of the team.     

医院ICU超声检查流程重组实践

通过在ICU增设超声检查设备,开展医生超声检查技能培训,做好信息技术保障,闭环监管等来进行ICU超声检查流程重组。实践后,ICU超声检查项目种类与工作量同比增长,各方满意度大幅度提升。ICU超声检查流程重组使ICU医疗效率提升,医疗质量安全更有保障,但仍需进一步加强ICU医生超声业务能力培训,合理推广,促进资源合理配置。     

ICU综合征的护理干预

目的探讨预防及治疗ICU综合征的护理措施。方法选择ICU病区的清醒住院患者124例,随机分为对照组和实验组各62例。从入住ICU第一天开始,对照组按危重病人传统护理常规护理;实验组在常规护理基础上,对病人实施认知、心理、行为、环境几方面护理干预,观察两组患者的预后。结果实验组发生ICU综合征主要症状情况明显比对照组减少,在ICU平均住院时间短,增加了患者及家属对医护人员的满意度。结论实施可行的护理干预能有效降低ICU综合征的发生,即使发生ICU综合征后也可通过护理干预,减轻患者不良心理,提高治疗效果。     

Working process in health and nursing at a neonatal ICU

This paper aims to analyze the work process at a university hospital neonatal ICU in Cuiabá-MT. The data were collected through participant observation and documents. The results showed that concerning collective work, the main aim is diagnosis and therapy, with the medical act as its central nucleus, since this professional detains the work rationality. Situations of complementarity and interdependence were observed in the team's work, with moments of negotiation among nursing agents and physicians. The technological work organization at the neonatal ICU still shows in its daily life the images of a routine and technical work, marked by the preterm weak body appropriation, which characterizes the biologist and cure model of care.     

ALCOHOL-RELATED ADMISSIONS TO AN INNER CITY HOSPITAL INTENSIVE CARE UNIT

We investigated the impact of alcohol-related medical emergencieson health care utilization in an inner city hospital medicalintensive care unit (ICU). Data from 200 consecutive admissionsto the medical ICU were collected prospectively The major reasonfor each patient's admission to the ICU was recorded and thecausal relationship between alcohol abuse and the admissiondiagnosis was determined. Clinical and demographic data as wellas the insurance status and cost of goods and services deliveredwere determined for all patients. Twenty-one per cent of allthe ICU admissions were directly alcohol-related, with a meanhospital charge o$52,527. The alcohol-withdrawal syndrome wasthe commonest alcohol-related admission, with a mean ICU stayof 5 days and a mean hospital charge of $21,336. Of the patientswith non-alcohol related admission diagnoses, 61% had healthinsurance, compared to 42% for the patients with alcohol-relatedadmission diagnoses (P< 0.05). Patients with alcohol-relatedadmissions tended to be younger and male. In conclusion, wedemonstrated that alcohol-related admissions are common in innercity hospital ICUs and consume considerable hospital resources.The treatment of these patients is costly, with hospitalizationbeing essentially non-curative. In this era of health care reform,more effective primary and secondary preventative measures arerequired to control this pervasive health care problem.     

三舱七门式医用空气加压氧舱群的ICU功能设计

介绍了新建三舱七门式医用空气加压氧舱群的ICU功能设计、监护抢救设备的配置和氧舱的功能特点。